Melanoma

Question 1

What is the treatment of stage 1 Melanoma?

Answer 1

wide local excision

Question 2

What is the treatment of stage 2 Melanoma?

Answer 2

WLE
SNLBx
Imaging
Trials

Question 3

What is the treatment of stage 3 Melanoma

Answer 3

Total LN dissection

Clinical Trials

Question 4

What is the treatment of stage 4 Melanoma

Answer 4

1. Mastatectomy if possible ( single lesion able to be completely resected)
2. BRAF status
   - if positive Debrafenib(BRAF) and Trametinib(MEK)
3. PD 1 - pembro

Question 5

RF for melanoma

Answer 5

• UVA and B exposure - most important causative agent
  
  • > 10 dysplastic naevi
  • > 100 common naevi
  • Fair skin /red hair
  • High intermittent sun exposure
  • Age

Question 6

Diagnosis of Melanoma?

Answer 6

• Assymetry 
	• Border uneven 
	• Colour - multiple
	• Diameter > 6 mm
Enlargement or evolution - bleeding is poor prognostic sign

Question 7

Types of melanoma?

Answer 7

Radial
1. Superficial spreading - most common, intermittent sun
2. Lentigo maligna - cummulative sun, mostlu on face
3. Acral lentiginous - not related to son on palms, soles, nails
Vertical
1. Nodular - poor prognosis, rapidly growing

Question 8

Staging of melanoma 1-4?

Answer 8

1 - localised under 1mm Breslow thickness
2 - larger localised
3 - positive LN
4 - Mets